title: Commentary: the five Ws of a Fracture Liaison Service: why, who, what, where, and how? In osteoporosis, we reap what we sow.
abstract: Establishing a Fracture Liaison Service (FLS) to identify and treat patients with a recent fragility fracture has been shown to be effective, save money, useful to document high quality of care, and makes good clinical sense. A FLS starts with an osteoporosis champion and encompasses identification of patients with a recent fracture, diagnostic workup, treatment, and follow-up. A FLS is most effective when it is able to function in multiple settings: the hospital, emergency department, and outpatient clinic. Implementation may be somewhat easier in a closed healthcare system but can be feasible even in an open system. There are many barriers to implementation which can be addressed. The future of FLS care lies in a collaborative systems-based approach with appropriate stakeholder engagement, leading to seamless integration of osteoporosis care.
authors.affiliation: Division of Clinical Immunology and Rheumatology, University of Alabama at Birmingham, 510 20th Street South, FOT 802D, Birmingham, AL, 35294, USA, jcurtis@uab.edu.
authors.forename: Jeffrey R
authors.initials: JR
authors.lastname: Curtis
authors.forename: Stuart L
authors.initials: SL
authors.lastname: Silverman
mesh_terms: D003695:Delivery of Health Care; D019468:Disease Management; D050723:Fractures, Bone / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D006801:Humans; D010024:Osteoporosis / Q000150:complications*; D058866:Osteoporotic Fractures / Q000517:prevention & control / Q000628:therapy*; D011787:Quality of Health Care; D055502:Secondary Prevention